Last week's health forum at NUI Galway heard that our senior generation are an 'ignored demographic' who have a valuable role to play in society, writes LORNA SIGGINS
THE SENIOR generation should be seen as a "demographic bounty" who can contribute an enormous amount to society, the Irish Times/Pfizer Health Forum heard at NUI Galway last week.
Serious inadequacies in supporting the health needs of the elderly, along with deficiencies in the Government’s Fair Deal scheme for financing nursing-home care, were also highlighted at the forum, which was attended by several hundred people.
The meeting, on the theme of "the ignored demographic – older people in Ireland", was chaired by Irish Timesassistant editor Fintan O'Toole. The panellists were Minister of State for Older People Áine Brady, Merlin Park Hospital consultant in geriatric medicine Dr Shaun O'Keeffe, Age Action chief executive Robin Webster, and Active Retirement chief executive Maureen Kavanagh.
Introducing the discussion, O'Toole said the subject was a "rubric under which a vast number of very important topics gather", and he referred to the "moving" television interview with Michael Noonan on RTÉ's The Frontline, broadcast on May 31st, where the former Fine Gael leader spoke about coping with his wife's Alzheimer's.
Brady said “we need to be prepared for an increase in the incidence” of Alzheimer’s and dementia, and there was a need for earlier diagnosis and specially trained carers.
O’Keeffe said that, in spite of recent advances, there were still issues around high-quality care, as one in five or one in six people has a chance of developing clinically diagnosed dementia.
Community services “have to be a priority”, as “people will be better in their own homes”, with adequate care, he stressed.
Kavanagh said that access to information was vital, as the earlier a diagnosis was made the better for everyone. Webster said that there was a crisis, both in provision and in planning, and there was far too much reliance on family carers who were working around the clock.
Several healthcare professionals in the large audience criticised the stress caused to old people by a carer-training system that does not allow participants on Fás or community employment schemes to remain with a patient for more than three years.
There was also criticism of the Fair Deal scheme for financing nursing home care, and of the lack of vital therapies available to people in private nursing homes, including physiotherapy and occupational therapy.
O’Keeffe, who had “ideological objections” to Fair Deal when it was initiated, was most concerned about its impact on public long-stay beds.
“There is a cohort of patients whose specific needs are best met in public long-stay units”, although private nursing homes did a “marvellous job”, he said.
Loretta Murray Clarke, who was in the audience, appealed to the Minister and panel to study the John Grant principle, as pursued by the Western Alzheimer’s care service. This involves limiting nursing home size to 20 beds, and has been very successful.
Responding, Grant, who was also among the audience, described how his association offered 434,000 care hours last year, and received 30 per cent of its funding from the State – with the majority raised by voluntary effort.
He said it was “very evident” that most carers were “prisoners in their own homes”, who were afraid to ask for more respite hours in case “they lost what they have”. His association’s units in Ballindine, Co Mayo, and Athenry, Co Galway, were “activity” rather than “nursing” homes, and the emphasis was on treating everyone as an individual.
“If you are going to do it, you have to do it right,” said Grant.
O’Keeffe said that medical professionals believed hospital management was finding it “easier to let wards close” than to meet the targets required by the Health Information Quality Authority (Hiqa).
Brady said that Hiqa was “not going around condemning buildings”, and was committed to “patient-centred care”, including “activities” for older people. Nor was the Government “driving people away from public to private facilities”, she said, but she acknowledged a “major glitch” with Fair Deal in relation to younger people requiring nursing home care.
Kavanagh said the recession had hit many of her members, with the carbon tax and prescription costs eating into the budgets of older people on limited incomes. The cut in the Christmas pension bonus also represented a 2 per cent loss to recipients of the State pension, she said.
However, her members were also “very good at managing budgets”, she said, and they would like to engage with younger people who may not have had the experience of recession.
Many of the positive attributes and experiences of older people were “invisible” in a society that determined people’s worth by their work or their younger age, said Kavanagh. She recalled the words of Prof Eamon O’Shea of NUI Galway’s Irish Centre for Social Gerontology, who had said that ageing in society “has to be seen as a demographic bounty that we need”.
“When you think of it, less than 5 per cent of the ageing population needs long-term healthcare, and our active retirement groups have a membership of 22,000, of which 3,000 are volunteers,” Kavanagh said.
“A lot of Government policies focus on those who contribute to society, and this should include this grouping, which has endless skills to offer.”
Agreeing with her, O’Keeffe recalled the writer JB Priestley, who said that “when he was young, there was no respect for the young, and when he was older, the same applied”.
O’Keeffe said that a colleague in Limerick often used two slides in presentations – one of Peig Sayers of the Blasket Islands and one of the singer Cher, both of them aged 64 at the time of being photographed. The fact that Leonard Cohen was yet again sold out also spoke volumes, he said.
O’Keeffe also noted that a substantial amount of clinic time in Galway was taken up with “people who read too much about Alzheimer’s”. Most people were “entitled to slippage and some senior moments”, he noted.
In a statement issued after the forum last week, Brady said that the Fair Deal scheme “is available to everyone who needs long-term nursing home care . . . regardless of their age”. She acknowledged that individuals with young families who required nursing home care had “additional expenses to meet”, and she said she had the power to “make regulations providing for allowable deductions to be taken account of during the financial assessment”.
This issue was under “active consideration by the department at present”, she said. More than 10,500 applications had been received for the Fair Deal scheme, she added.